Efficacy of Surgery on Improvement of Locomotive Syndrome in Older Patients With Lumbar Spinal Stenosis: Comparison With the General Older Population.

AIM: To investigate whether surgery can improve lumbar spinal stenosis (LSS) to the same level as locomotive syndrome (LS) in the general older population and when surgery should be performed in LSS patients.

METHODS

We included patients aged ≥ 65 years who underwent surgery for LSS. The healthy older group consisted of older adults aged ≥ 65 years who underwent an LS test in a health examination. We compared the degree of LS and examined the background factors of patients who underwent surgery for LSS with and without improvement in post-operative LS. We then determined the cutoff values using receiver operating characteristic curve analysis.

RESULTS

There was a significant difference in the distribution of LS stages between the post-operative patient group and the healthy older adult group. Poor improvement in LS was significantly associated with female sex and low Prognostic Nutritional Index. The cutoff value for post-operative LS less than Stage 2 was 37 points for the Geriatric Locomotive Function Scale-25 (GLFS-25) score.

CONCLUSION

Surgery for LSS significantly improved LS, but not to the same stage as that in the healthy older group. The appropriate timing of surgery to maintain mobility and prevent LS progression was scored as 37 points on the GLFS-25.